September 1, 2020
We have heard this statement multiple times but how truly transformational is it to replace paper with digital to replicate current processes? To deliver real change requires innovation, and this innovation will not come from the incumbent suppliers of today who are delivering e-health solutions using 20th Century technology based on business models that lock data in proprietary formats and customers into obsolete systems. We will need to do things differently.
Outside of health and care, we have seen how digital platforms have transformed how we book travel, do shopping and manage our finances. In health and care however, barriers to market entry including governance, regulations, culture, plus the complexity and longevity of data, mean that it is extremely difficult for new players to deliver innovative new solutions at scale. Thus, health and care providers are at the mercy of a decreasing number of solution providers who are making ever increasing profit margins.
This presents real problems to providing sustainable and affordable health and care. Especially given the growing demands and spiralling costs of aging populations and the management of complex long-term conditions.
In Sweden, Cambio has delivered our COSMIC solution to the majority of Sweden’s counties which are seen by some as a blueprint for integrated health and care processes. The Swedish healthcare system is often seen as being one of the most effective in the world and COSMIC is a symbiotic part of this. However, any large scale electronic patient record system, COSMIC included, cannot keep pace with the rate of innovation in healthcare, resulting in the creation of unregulated systems, sometimes referred to as ‘shadow IT’, ‘feral’ or ‘homebrew’ systems. This is a growing problem.
At Cambio, we believe that open digital platforms, based on open standards such as openEHR, have the potential to transform the way that health and care is delivered, in a similar way that Amazon and eBay have transformed the way that we purchase goods. Open platforms have the potential to lower the barrier of entry for new innovations, facilitating the creation of an ecosystem where health and care communities can be confident that the data stored in the platform is portable, and where they have choice in the applications, based upon quality of service rather than being forced to take the only solution that runs on a proprietary data model from a single supplier.
To this end, we see openEHR as the only scalable, viable solution for storing clinical data for the lifetime of a patient.
Cambio was one of the first suppliers to pioneer openEHR solutions and we are an active member of the openEHR Foundation. Our own Dr. Rong Chen developed openEHR’s GDL (Guideline Definition Language) upon which our advanced Cambio CDS (Clinical Decision Support) Platform is based. We are also investing in our openEHR capability within COSMIC to allow key clinical objects to be stored as openEHR archetypes.
Looking further ahead, we are investing in research and development of our own open platform based around open standards such as openEHR, HL7 FHIR, SNOMED-CT and IHE-XDS. As part of this, we are really focusing on how organisations will leverage the benefits of an open platform whilst also recognising the investment that many organisations have made into the current ‘mega-suites’ of today which are based on legacy technologies.